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Application for ASIST 11.1 Materials
In an effort to subsidize costs passed on to ASIST training participants in Colorado, the Office of Suicide Prevention is pleased to consider your application for free ASIST 11.1 training materials for use in the workshops you facilitate. After completing the application, we will be in touch to review the details of your request.
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Email
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Your email
Organization Name
Your answer
Trainer Name, if identified
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Your answer
Trainer ID Number
Your answer
Phone number
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Your answer
Please provide a short description of why materials are needed for your training project.
Your answer
Colorado counties that you plan to offer trainings in:
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Your answer
Average number of attendees per training:
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Your answer
Shipping Contact / Company
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Your answer
Shipping Address - Street
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Your answer
Shipping Address - City
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Your answer
Shipping Address - State
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Your answer
Shipping Address - Zip Code
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Your answer
ASIST 11.1 Participant Kit (English) includes the workbook, wallet card, certificate, feedback form, stickers, brochure. How many participants kits are you requesting?
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Your answer
When do you need the materials by?
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YYYY
If we are able to subsidize the cost of materials for you, what do you plan to charge participants to attend ASIST?
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